Jin Xiao-Xiao, Sun Ling, Lai Xiao-Li, Li Jie, Liang Mei-Li, Ma Xia
Department of Obstetrics and Gynecology, Zhejiang Taizhou Hospital, Taizhou 317000, Zhejiang Province, China.
World J Clin Cases. 2022 Jan 14;10(2):511-517. doi: 10.12998/wjcc.v10.i2.511.
Improper methods of contraception greatly increase the risk of abortion, cervical or endometrial lesions, and the number of recurrent artificial abortions. These complications result in the deterioration of a patient's outcome. Further, the proportion of artificial abortions is highest among unmarried females. Placement of an intrauterine device, such as the Mirena, after an artificial abortion may decrease the likelihood of an endometrial injury caused by recurrent abortions while significantly improving its contraceptive effects.
To discuss the effect of Mirena placement on reproductive hormone levels at different time points after an artificial abortion.
Women ( = 119) undergoing an artificial abortion operation were divided into the study ( = 56) and control ( = 63) groups. In the study group, the Mirena was inserted immediately after the artificial abortion, whereas in the control group, it was inserted 4-7 d after the onset of the first menstrual cycle after abortion. All participants were followed-up for 6 mo to observe the continuation and expulsion rates and adverse reactions and to measure the levels of serum estradiol (E2), follicle stimulating hormone (FSH), and luteinizing hormone (LH).
The continuation rates were 94.64% and 93.65% in the study group and the control group, respectively. The expulsion rates were 1.79% and 3.17% in the study group and the control group, respectively. There was no statistically significant difference between the two groups ( > 0.05). There were also no statistically significant differences in the proportion of patients with bacterial vaginitis, trichomonas vaginitis, or cervicitis between the groups ( > 0.05). Six months after Mirena placement, E2 Levels were 45.50 ± 7.13 pg/mL and 42.91 ± 8.10 pg/mL, FSH 13.60 ± 3.24 mIU/mL and 14.54 ± 3.11 mIU/mL, and LH 15.11 ± 2.08 mIU/mL and 14.60 ± 3.55 mIU/mL in the study and control groups, respectively. There were no significant differences in hormone levels between the two groups ( > 0.05). There were also no statistically significant differences in the proportions of abnormal menstruation, prolonged menstruation, or pain during intercourse between the study and control groups after Mirena placement ( > 0.05). There were no statistically significant differences in uterine volume, sexual desire, sexual activity, or the sexual satisfaction score between the study and control groups before and after Mirena placement ( > 0.05).
Placement of a Mirena intrauterine device immediately after an artificial abortion does not increase the risk of adverse reactions and can help prevent endometrial injury caused by recurrent abortions.
避孕方法不当会大大增加流产、宫颈或子宫内膜病变以及反复人工流产的风险。这些并发症会导致患者预后恶化。此外，人工流产比例在未婚女性中最高。人工流产后放置宫内节育器（如曼月乐）可能会降低反复流产引起的子宫内膜损伤的可能性，同时显著提高其避孕效果。
探讨人工流产后不同时间点放置曼月乐对生殖激素水平的影响。
将接受人工流产手术的女性（n = 119）分为研究组（n = 56）和对照组（n = 63）。研究组在人工流产后立即插入曼月乐，而对照组在流产后第一个月经周期开始后4 - 7天插入。对所有参与者进行6个月的随访，观察续用率、脱落率和不良反应，并测量血清雌二醇（E2）、卵泡刺激素（FSH）和黄体生成素（LH）水平。
研究组和对照组的续用率分别为94.64%和93.65%。研究组和对照组的脱落率分别为1.79%和3.17%。两组之间无统计学显著差异（P > 0.05）。两组之间细菌性阴道炎、滴虫性阴道炎或宫颈炎患者的比例也无统计学显著差异（P > 0.05）。放置曼月乐6个月后，研究组和对照组的E2水平分别为45.50 ± 7.13 pg/mL和42.91 ± 8.10 pg/mL，FSH分别为13.60 ± 3.24 mIU/mL和14.54 ± 3.11 mIU/mL，LH分别为15.11 ± 2.08 mIU/mL和14.60 ± 3.55 mIU/mL。两组激素水平无显著差异（P > 0.05）。放置曼月乐后，研究组和对照组在月经异常、经期延长或性交疼痛的比例方面也无统计学显著差异（P > 0.05）。放置曼月乐前后，研究组和对照组在子宫体积、性欲、性活动或性满意度评分方面无统计学显著差异（P > 0.05）。
人工流产后立即放置曼月乐宫内节育器不会增加不良反应的风险，且有助于预防反复流产引起的子宫内膜损伤。
